PROCEDURE
Using ultrasound guidance, common femoral artery
was accessed using the finder needle. The micro dilator introducer
sheath was put in place without any resistance and this was exchanged
for an 0.035 J wire. The left common femoral artery was cannulated in
a similar fashion under ultrasound guidance. Ultrasound pictures were
taken of both and sent off to the chart. With both 0.035 wires in
place, the 6-French sheath was put in place under fluoroscopic
guidance. The 6-French sheath was then withdrawn and ProGlides were
put in place in standard Pre-close fashion. 8F sheaths were then placed
into the abdominal aorta.
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A KMP and a Glidewire were used to
get access into the thoracic aorta. This was exchanged for a
Supertiff amplatz wire and the position was marked on the right-hand side.
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The main body device was then placed through on the R side. The main body device was then deployed just distal to the lowest renal artery until the contralateral
gate was opened. The contralateral gate was then cannulated. We assured that the wire was truly in the lumen of the device using the catheter spin technique with a pigtail catheter.
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We then performed contralateral pelvic angiography to identify the iliac bifurcation. Based on this we decided on a 16x16x124 contralateral limb device. The limb was deployed just proximal to the iliac bifurcation without difficulty.
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Ipsilateral iliac angiogram was then performed through the ipsilateral sheath. We then completed the main body deployment on the ipsilateral side. NO additional ipsilateral limb was deployed.
The seal zones both proximal and within both limbs were
ballooned using a compliant balloon.

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